Sonography for diagnosis and follow‐up of neonatal adrenal hemorrhage

Abstract

Neonatal adrenal hemorrhage was diagnosed by ultrasound as an echo-free mass superior to downward displaced normal kidneys in three newborns. In one, the adrenal hemorrhage was bilateral. Fine needle aspiration was performed to confirm the diagnosis in one case. The babies were followed-up until adrenal calcifications were seen on ultrasound as linear echoes with posterior acoustic shadowing. These calcifications were confirmed by plain films. It is suggested that the diagnosis of neonatal adrenal hemorrhage should be based on ultrasound and on one initial intravenous urogram. Follow-up examinations should be restricted to ultrasound and plain films. In doubtful cases fine needle aspiration can be added for confirmation.

Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice

“…The mass representing the adrenal hemorrhage should decrease. [78] If the mass has a solid component, if color doppler USG reveals blood flow over mass, and if CECT shows enhancement of the mass, neuroblastoma needs to be ruled out. The patient should be carefully followed up with USG.…”

Unsuspected adrenal masses in the neonate: adrenal cortical carcinoma and neuroblastoma

“…However, there have been relatively few reports of neonatal adrenal hemorrhage in the ultrasound literature. In these reports, adrenal hemorrhage has been described as echo free [8,9], mixed [10,11] and echogenic [10] with a decrease in size and variable changes in the echogenicity of the hemorrhage with time as common factors [10]. In contradistinction, the two cases presented here showed no decrease in size and were consistent in echogenicity over time and in this way could be differentiated from hemorrhage.…”

Adrenal Hemorrhage as a Rare Cause of Neonatal Anemia Associated with Hydrocephalus Secondary to Intraventricular Hemorrhage—A Case Report

“…24-hour urinary excretion of VMA should be done, since an increase in VMA is virtually diagnostic of neuroblastoma [10]. Other differential diagnosis of AH are neonatal adrenal abscess, cortical renal cyst, obstructed upper cortical renal cyst and an obstructed upper excretory tract in the duplicated kidney [11].…”